Abstractor/Coder I

Abstractor/Coder

Under moderate supervision, the Abstractor/Coder is responsible for accurate and timely review and coding of inpatient and outpatient physician services including procedures and surgeries. Ensure that all external regulations affecting the coding process are administered to compliance. Review physician reports and append appropriate CPT, HCPCS, ICD-10 codes, and modifiers verifying that physician documentation supports the billing. Perform and facilitate accurate charge capture of physician services through the review of provider documentation to abstract and/or validate ICD and CPT codes.

Responsibilities include:

• Obtain appropriate reimbursement levels for professional services by reviewing and coding physician services including but not limited to procedures, evaluation and management services, diagnoses, and modifiers.
• Analyze denial and rejection reports, and appeal wherever appropriate.
• Submit charges in a timely manner.
• Work in collaboration with the team to provide guidance to faculty and staff on the charge capture and documentation processes.
• Work in collaboration with clinical revenue management and others, provide guidance to faculty and staff on the charge capture and documentation processes.
• Educate physicians and support staff on coding issues, including issues related to fraud.
• Assign appropriate CPT, HCPCS and ICD-10 codes for professional services as per designated workflow.
• Review and resolve edits resulting from these services in a timely manner.
• Query physicians to clarify conflicting, imprecise, incomplete, ambiguous, and/or inconsistent documentation when appropriate.
• Ensure coding compliance to all relevant internal and external regulations.
• Other duties as assigned.

Competencies include:

• High-level proficiency in medical terminology, anatomy and physiology, ICD-10, HCPCS and CPT coding classification systems as demonstrated by certification through a nationally accredited body (e.g., AAPC or AHIMA) required.
• Must demonstrate exceptional attention to detail with a commitment to accuracy in coding and billing processes.
• Understanding of CMS guidelines, familiarity with third-party payer rules and reimbursement policies.
• Proficiency in Microsoft Word, Excel and Adobe required.
• Communicate effectively in English, both orally and in writing.
• Manage interpersonal relationships and interact/communicate with clarity, tact and courtesy with patrons, patients, staff, faculty, students and others.
• Identify priorities; recognize and resolve or refer problems; work effectively with supervision and as a part of a team; use or learn a range of position-related software applications.

Additional responsibilities include:

• Education: High School Diploma or equivalent required.
• Experience: Minimum of 2 years of coding experience required; other relevant experience with exceptional coding knowledge may be considered in lieu of direct coding experience.
• Two or more years of experience coding in surgical specialties preferred.
• Prior experience with Epic Professional Billing preferred.
• Prior experience coding in an academic medical center preferred.
• Licenses and Certifications: Must have one of the following: Registered Health Information Administrator [RHIA], Registered Health Information Technician [RHIT], Certified Coding Specialist-Physician-based [CCS-P], Certified Professional Coder [CPC], or Certified Coding Specialist [CCS]), required.

Technical knowledge or skills include:

• Proficiency in ICD-10-CM, CPT, and HCPCS Level II coding systems.
• Proficiency with Microsoft Office suite required.
• Ability to utilize encoders and other online tools to research, validate and assign accurate codes.

Working conditions and physical requirements include:

• Standard Office Environment.
• Use Standard Office Equipment.
• Sit for 4 hours or more.
• Flexible work arrangements, including remote work options for coders in good standing.

Pay Range: $25.95 - $37.98 hourly.

Required Documents: Resume, Cover Letter.

When applying, the documents MUST be uploaded via the My Experience page, in the section titled Application Documents of the application.